Metabolic associated fatty liver disease (MAFLD) can progress to liver fibrosis, leading to an increased risk of related decompensation. Investigation into the mechanisms, early diagnosis, and accurate staging of MAFLD-related liver fibrosis are critical to patient prognosis. MicroRNA, which are involved in post-transcriptional regulation, play significant roles in the initiation and progression of liver fibrosis. They exhibit aberrant expressions across different stages of liver fibrosis and are stably present in body fluids, suggesting their potential as novel circulating biomarkers. This article reviews the research on the mechanisms through which microRNA promote or inhibit MAFLD-related liver fibrosis and on their diagnostic value and therapeutic potential.